Article ; Online: Predictors of patient and graft survival following pediatric liver transplantation: Long-term analysis of more than 300 cases from single centre.
2021 Volume 26, Issue 1, Page(s) e14139
Abstract: Background: Pediatric liver transplant (PLT) activity has flourished over time although with limited expansion in the graft pool. The study aims to identify pre-transplant factors that predict post-transplant patient and graft survival in the PLT ... ...
| Abstract | Background: Pediatric liver transplant (PLT) activity has flourished over time although with limited expansion in the graft pool. The study aims to identify pre-transplant factors that predict post-transplant patient and graft survival in the PLT population. Methods: Retrospective review of PLTs at a single tertiary transplant unit from 2000 to 2019. Univariate and multivariate analyses of pre-transplant factors were performed to identify predictors of patient and graft survival. Results: Two hundred and seventy-six patients received 320 PLTs. The most common cause of graft loss was hepatic artery thrombosis (n = 13, 29.6%). The most common cause of mortality was sepsis (n = 11, 29.7%). Univariate analysis showed that the following variables had a significant (p < .05) impact on patient survival: recipient age, weight, height, graft type (technical variant graft), transplant category (acute liver failure), the era of transplant, and invasive ventilation. The following variables had a significant (p < .05) impact on graft survival: recipient age, weight, height, transplant category (acute liver failure), and the era of transplant. Multivariate analysis precluded the era of transplant as the only significant factor for patient survival; patients transplanted after 2005 had significantly higher patient survival. No independent factor predicting graft survival was identified. For children transplanted after 2005, the only factor that predicted patient survival was pre-transplant invasive ventilation. Conclusions: Our study suggests that the learning curve and pre-transplant invasive ventilation in the recipient have a significant impact on patient survival. The traditional view of worse outcomes of smaller PLT candidates should be changed. |
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| MeSH term(s) | Adolescent ; Child ; Child, Preschool ; End Stage Liver Disease/mortality ; End Stage Liver Disease/surgery ; Female ; Graft Survival ; Humans ; Infant ; Infant, Newborn ; Liver Transplantation/mortality ; Male ; Multivariate Analysis ; Postoperative Complications/mortality ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Treatment Outcome |
| Language | English |
| Publishing date | 2021-09-20 |
| Publishing country | Denmark |
| Document type | Journal Article |
| ZDB-ID | 1390284-2 |
| ISSN | 1399-3046 ; 1397-3142 |
| ISSN (online) | 1399-3046 |
| ISSN | 1397-3142 |
| DOI | 10.1111/petr.14139 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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